Nurture Early for Optimal Nutrition (NEON): A pilot cluster randomised controlled trial of community-facilitator-led participatory learning and action womens groups to improve infant feeding & care among South Asian families in East London
- 1UCL: University College London
Abstract
South Asian communities in the UK experience disproportionate maternal and child health inequalities linked to non-recommended infant feeding practices, limited health literacy, and socioeconomic constraints. Participatory learning and action (PLA) is effective in low- and middle-income countries, but high-income evidence is scarce. This pilot assessed the feasibility of a community facilitator-led PLA intervention to improve infant feeding among South Asian families in East London.
A three-arm pilot feasibility cluster randomised controlled trial (ISRCTN10234623) was conducted in Tower Hamlets and Newham, East London (May-September 2022), with 12 wards randomised 1:1:1 to face-to-face PLA, online PLA, or usual care. Multilingual community facilitators delivered eight biweekly sessions over 14 weeks. Feasibility outcomes were assessed against prespecified Go/Stop criteria; exploratory outcomes included child feeding behaviours (Childrens Eating Behaviour Questionnaire, CEBQ), parental feeding style (Parental Feeding Style Questionnaire, PFSQ), and child BMI Z-scores.
Of 263 enrolled participants, 261 had a recorded trial arm allocation; consent to the pilot feasibility study was 70.7% (186/263; 95% CI 65.0-75.9%) meeting the [≥]50% Go criterion. Attendance was 37% (Tower Hamlets 59%, Newham 29%), below the [≥]80% Go threshold. Six-month retention was 54.8% (Tower Hamlets 78%, Newham 48.5%; 95% CI 41.8-55.3%), triggering the Definite Stop criterion. Significant baseline imbalances included BMI Z-score (p = 0.005), ethnicity, borough, and education; no between-arm BMI differences were observed at follow-up (p = 0.249). CEBQ and PFSQ baseline completion was 24.5% and 23.0%, with no usable follow-up data. PLA Phases 3 and 4 were not completed by any group; all participants providing feedback reported it acceptable.
Recruitment was feasible and the intervention acceptable, but a Definite Stop criterion was triggered in Newham, no group completed the full PLA cycle, and outcome data were insufficient for evaluation. A definitive trial requires stratified randomisation, digitised multilingual data collection, participant reimbursement, and explicit PLA phase-completion criteria.
Trial registrationISRCTN10234623 (IRAS ID: 296259; Ethics Ref: 21/SW/0142).
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BibTeX
@misc{manikam2026nurture,
title = {{Nurture Early for Optimal Nutrition (NEON): A pilot cluster randomised controlled trial of community-facilitator-led participatory learning and action womens groups to improve infant feeding & care among South Asian families in East London}},
author = {L. Manikam and A. Fatima and P. Patil and C. A. Mayadewi and T. El Khatib and J. Drazdzewska and O. Oyebode and C. H. Llewellyn and K. Webb-Martin and C. Irish and M. Archibong and J. Gilmour and P. Kalungi and N. Batura and K. Shringarpure and M. Lakhanpaul and M. Heys and NEON Steering Team},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.28.26361604},
url = {https://www.medrxiv.org/content/10.64898/2026.08.28.26361604v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Nurture Early for Optimal Nutrition (NEON): A pilot cluster randomised controlled trial of community-facilitator-led participatory learning and action womens groups to improve infant feeding & care among South Asian families in East London
AU - L. Manikam
AU - A. Fatima
AU - P. Patil
AU - C. A. Mayadewi
AU - T. El Khatib
AU - J. Drazdzewska
AU - O. Oyebode
AU - C. H. Llewellyn
AU - K. Webb-Martin
AU - C. Irish
AU - M. Archibong
AU - J. Gilmour
AU - P. Kalungi
AU - N. Batura
AU - K. Shringarpure
AU - M. Lakhanpaul
AU - M. Heys
AU - NEON Steering Team
PY - 2026
DA - 2026/08/28
PB - medRxiv
DO - 10.64898/2026.08.28.26361604
UR - https://www.medrxiv.org/content/10.64898/2026.08.28.26361604v1
AB - South Asian communities in the UK experience disproportionate maternal and child health inequalities linked to non-recommended infant feeding practices, limited health literacy, and socioeconomic constraints. Participatory learning and action (PLA) is effective in low- and middle-income countries, but high-income evidence is scarce. This pilot assessed the feasibility of a community facilitator-led PLA intervention to improve infant feeding among South Asian families in East London. A three-arm pilot feasibility cluster randomised controlled trial (ISRCTN10234623) was conducted in Tower Hamlets and Newham, East London (May-September 2022), with 12 wards randomised 1:1:1 to face-to-face PLA, online PLA, or usual care. Multilingual community facilitators delivered eight biweekly sessions over 14 weeks. Feasibility outcomes were assessed against prespecified Go/Stop criteria; exploratory outcomes included child feeding behaviours (Childrens Eating Behaviour Questionnaire, CEBQ), parental feeding style (Parental Feeding Style Questionnaire, PFSQ), and child BMI Z-scores. Of 263 enrolled participants, 261 had a recorded trial arm allocation; consent to the pilot feasibility study was 70.7% (186/263; 95% CI 65.0-75.9%) meeting the [≥]50% Go criterion. Attendance was 37% (Tower Hamlets 59%, Newham 29%), below the [≥]80% Go threshold. Six-month retention was 54.8% (Tower Hamlets 78%, Newham 48.5%; 95% CI 41.8-55.3%), triggering the Definite Stop criterion. Significant baseline imbalances included BMI Z-score (p = 0.005), ethnicity, borough, and education; no between-arm BMI differences were observed at follow-up (p = 0.249). CEBQ and PFSQ baseline completion was 24.5% and 23.0%, with no usable follow-up data. PLA Phases 3 and 4 were not completed by any group; all participants providing feedback reported it acceptable. Recruitment was feasible and the intervention acceptable, but a Definite Stop criterion was triggered in Newham, no group completed the full PLA cycle, and outcome data were insufficient for evaluation. A definitive trial requires stratified randomisation, digitised multilingual data collection, participant reimbursement, and explicit PLA phase-completion criteria. Trial registrationISRCTN10234623 (IRAS ID: 296259; Ethics Ref: 21/SW/0142).
ER -